氯吡格雷对兔髂腹动脉球囊损伤后新生内膜的影响

目的： 观察氯吡格雷对兔髂腹动脉球囊损伤后内膜增生的影响和作用机制。方法: 37只新西兰兔随机分为正常组、模型组、氯吡格雷组及阿托伐他汀组。高脂喂养加髂动脉内膜剥脱建立动脉粥样硬化模型。检测血脂和高敏C反应蛋白（hsCRP）。12周后观察动脉病理组织学改变并测量内膜、中膜厚度和面积，原位杂交检测血小板源性生长因子（PDGFmRNA）的表达，免疫组化测定凋亡基因Bcl-2和Bax的表达。结果： ①模型组血清hs-CRP、髂动脉内膜厚度和面积、PDGFmRNA、凋亡基因Bcl-2/Bax比值较正常组显著增加（P＜0.05,P＜0.01）；②氯吡格雷组血清hs-CRP、内膜厚度与面积、PDGFmRNA的表达、Bcl-2/Bax的比值小于模型组（P＜0.05,P＜0.01），血脂水平和模型组无明显差异；③氯吡格雷对上述指标的改变与阿托伐他汀无显著差异。结论： 氯吡格雷降低炎症反应、抑制PDGFmRNA表达、促进细胞凋亡，减轻高脂和球囊损伤后动脉内膜增殖。     

超声波辅助转染PDGF-B mRNA的反义寡肽核酸抑制兔动脉再狭窄

目的：探讨反义寡肽核酸在体内对血管平滑肌细胞增殖和再狭窄的影响。方法：建立兔髂动脉再狭窄模型，用合成的反义寡PNA作为药物以超声波辅助转导局部血管壁细胞，分别用原位分子杂交和LSAB免疫组织化学法检测PDGF-B mRNA和PCNA表达；用形态测量法检测血管内膜厚度和面积。结果： PNA显著抑制损伤后1周内膜VSMCs表达PCNA和PDGF-B mRNA，与对照组相比抑制率分别为84.19%和63.95%；显著减少血管内膜厚度和面积。 结论：反义寡PNA可阻止兔VSMCs增殖及内膜增生。     

丹参酮ⅡA纳米球对兔颈动脉球囊损伤后内膜增殖的抑制

制备丹参酮ⅡA纳米球．以用于观察局部灌注后对损伤血管内膜增殖的抑制。通过超声乳化法制备了PLGA包载的、载药量为1．55％土0．016％（mg／mg），平均粒径为119nm的丹参酮ⅡA纳米球，将其和空白纳米粒分别局部灌注于球囊损伤后的兔颈动脉内，对内膜增殖的情况进行分析。结果发现：28d丹参酮ⅡA纳米粒组与空白纳米粒组和动脉损伤模型组相比，内膜面积明显减少（P〈0．01）；空白纳米粒组与模型组的内膜面积比较，无明显变化（P=0．302）；内膜面积／中膜面积作为内膜增殖指数的指标，丹参酮ⅡA纳米粒组比动脉损伤模型组减少了39．7％。本实验成功地研制了丹参酮ⅡA纳米粒，局部灌注于内膜剥脱后的血管内，不仅证实了其组织相容性，而且显示出良好的局部摄取，以及显著抑制损伤血管内膜增殖的效应。     

瑞舒伐他汀对Medtronic球囊导管损伤大鼠颈动脉平滑肌细胞增殖及凋亡的影响

背景:球囊扩张及支架置入后再狭窄、管腔丢失等问题制约了支架置入治疗的进一步发展,血管内膜增殖和凋亡在再狭窄中的作用及干预方法尚在积极探索中。目的:采用Medtronic球囊建立大鼠颈动脉球囊损伤模型,观察瑞舒伐他汀对球囊损伤大鼠颈动脉平滑肌细胞增殖及凋亡的影响。方法:将雄性SD大鼠随机数字表法分为球囊损伤组和治疗组。均采用Medtronic球囊建立大鼠颈动脉球囊损伤模型,并取球囊损伤组大鼠的右侧颈总动脉(未行球囊损伤)作为正常对照。治疗组于球囊损伤前3d始连续给予瑞舒伐他汀5mg/(kg·d)灌胃,球囊损伤组给予9g/L氯化钠溶液灌胃。术后7,14d取颈总动脉进行苏木精-伊红染色,免疫组织化学检测SMα-actin、增殖细胞核抗原,采用TUNEL法检测平滑肌细胞凋亡情况。结果与结论:与球囊损伤组比较,治疗组造模后14d,损伤血管新生内膜面积、新生内膜/中膜面积比值明显减少(P0.05),管腔面积增加26%;增殖细胞核抗原阳性细胞率降低,凋亡阳性细胞率增高(P0.05)。提示支架置入球囊损伤前给予瑞舒伐他汀可抑制大鼠颈动脉球囊损伤后新生内膜增生及新生内膜细胞的增殖,促进平滑肌细胞的凋亡,从而减少动脉新生内膜形成,抑制再狭窄。     

糖尿病兔髂动脉球囊损伤后内膜增生的变化

目的：探讨糖尿病兔髂动脉球囊损伤后内皮再生和内膜增生的关系。方法：26只糖尿病兔和26只正常兔在行髂动脉内皮球囊剥脱术后0、1、2、3、4周，取髂动脉测定新生内皮面积及内膜面积。结果：糖尿病兔组在术后1、2周新生内皮面积明显小于对照组，术后1、2、3、4周新生内膜面积均显著大于对照组。结论：糖尿病兔髂动脉球囊损伤后内膜明显增生，可能与内皮修复延迟有关。     

实验性兔动脉损伤后血管外膜成纤维细胞的变化

目的探索动脉损伤后,血管外膜成纤维细胞的变化。方法以球囊导管法制模,通过病理形态学、免疫组织化学、计算机图像分析和透射电镜观察兔髂动脉损伤后各时间点血管外膜成纤维细胞的增殖与表型转化情况;并通过V染色血管外膜成纤维细胞的分布、测量面积并反映成纤维细胞表型转化后的合成与分泌功能。结果以球囊导管法制造兔髂动脉损伤动物模型100%成功,观察到损伤后外膜细胞首先发生增殖,成纤维细胞发生表型转化,并在电镜下观察到成纤维细胞的迁移现象。结论动脉损伤后,血管外膜成纤维细胞首先增殖,转化为肌成纤维细胞,表达α-肌动蛋白(α-actin),并向内膜转移。     

阿托伐他汀对大鼠自体移植静脉内膜增生的影响

目的： 探讨新型降脂药阿托伐他汀对自体移植静脉内膜增生的影响。 方法： 将Wistar大鼠颈外静脉移植于腹主动脉,建立大鼠自体静脉移植模型,实验分为3组：假手术组、移植对照组和移植实验组。自术后第1 d起,对移植实验组大鼠经胃管灌注给予阿托伐他汀(5 mg·kg-1·d-1)处理。干预4周后取移植静脉组织标本,制备4 μm厚组织切片,行病理组织学观察分析移植静脉内膜增生情况,行免疫组化染色分析新生内膜细胞SMα-actin和PCNA的表达情况。 结果： 移植对照组和实验组移植静脉内皮下层SMα-actin染色阳性平滑肌细胞大量增生,导致静脉内膜显著增厚,血管管腔明显狭窄。新生内膜定量分析显示移植实验组移植静脉内膜增生受到明显抑制,其新生内膜面积及新生内膜/中膜面积比均显著低于对照组(P<0.01);并且实验组移植静脉新生内膜细胞PCNA标记指数显著低于对照组(P<0.01)。 结论： 阿托伐他汀通过抑制新生内膜平滑肌细胞的增殖能有效抑制自体移植静脉内膜增生的发生发展,在防治血管重建术后再狭窄方面显示出良好的应用前景。     

转染VEGF165基因抑制兔动脉损伤后内膜增生

目的：观察局部转染血管内皮生长因子165（VEGF165）基因对损伤动脉内膜增生的影响并探讨可能机制。 方法： 采用显微外科手术方法，建立兔右髂外动脉损伤模型。将105只新西兰大白兔随机分为3组，每组35只。A组为生理盐水对照组，B组为脂质体介导的pBudCE4.1转染组，C组为脂质体介导的pBudCE4.1/VEGF165转染组。用微注射器将各种转染液注入损伤的血管壁，每组按实验终点（术后2、3、7、14和28 d）分为5个亚组，每个亚组7只兔。于术后各实验终点，取损伤段的血管用于病理组织学检查、电镜观察、RT-PCR和免疫组化染色检查。 结果： 术后各时点C组血管内膜厚度和内膜面积均显著小于A组和B组（P<0.01），术后28 d时C组管腔狭窄率平均比A组和B组低51.6%和49.8％。术后各时点C组血管壁的VEGF165基因的mRNA表达量和血管壁VEGF165阳性细胞率明显高于A组和B组（P<0.01）。C组血管壁血管内皮细胞（VEC）修复和生长增殖速度明显快于A组和B组。A组和B组间无明显差异。 结论： 局部转染VEGF165基因可抑制血管新生内膜增生及血管再狭窄，为将来血管内膜增生的基因治疗奠定基础。     

四逆汤对兔髂动脉球囊损伤病变区TGF-β1表达的影响

目的:通过球囊损伤兔髂动脉造成动脉损伤的模型，观察四逆汤对损伤后动脉内膜的保护和修复作用以及对转化生长因子β1（TGF-β₁）的影响。 方法:雄性新西兰兔24只，随机分为对照组、模型组、四逆汤治疗组（四逆汤组），每组8只。对照组给予普通饲料，模型组和四逆汤组给予高脂饮食。饲养2周后模型组、四逆汤组兔行髂动脉内膜剥脱术。术后4周处死各组实验兔，采用ELISA方法检测血清TGF-β₁水平；HE染色观察髂动脉内膜增生情况，通过免疫组化观察TGF-β₁蛋白在血管壁的表达；采用RT-PCR方法检测血管壁TGF-β₁ mRNA的表达。 结果:病理观察可见对照组兔髂动脉管腔和管壁厚度正常，管壁光滑；模型组的管壁明显增厚、管腔明显狭窄，内膜增厚；而治疗组管壁增厚较轻，管腔狭窄较轻，内膜增厚程度减轻。对照组兔血清TGF-β₁水平明显低于模型组和四逆汤组，四逆汤组又明显低于模型组（P<0.05）。免疫组化发现对照组兔髂动脉内膜TGF-β₁的染色灰度和染色阳性面积比明显小于模型组和四逆汤组，而四逆汤组TGF-β₁的染色灰度和染色阳性面积比明显小于模型组（P<0.05）。对照组兔髂动脉TGF-β₁ mRNA表达明显低于四逆汤组和模型组，而四逆汤组TGF-β₁ mRNA的表达少于模型组（P<0.05）。 结论:四逆汤可减轻兔髂动脉剥脱术后的内膜增生和血管的狭窄, 其机制可能与抑制髂动脉损伤后内膜TGF-β₁的基因和蛋白的表达，减少TGF-β₁的产生有关。     

瑞舒伐他汀对大鼠颈动脉球囊损伤后细胞凋亡的影响

目的观察瑞舒伐他汀对大鼠颈动脉球囊损伤后细胞凋亡的影响。方法36只雄性SD大鼠随机分为对照组、损伤组和治疗组,每组12只。损伤组和治疗组分别建立大鼠左侧颈动脉球囊损伤模型,右侧颈动脉未予球囊损伤。治疗组于损伤前3d始连续每天给予瑞舒伐他汀5mg／（kg·d）灌胃,对照组和损伤组予9g／L氯化钠溶液灌胃。术后14d取左侧颈总动脉,进行HE染色和末端脱氧核苷酸转移酶介导的生物素-dUTP缺口标记技术（Terminal deoxynucleotidyl transferase biotin—dUTP nick end labeling,TUNEL）的凋亡检测。结果共30只大鼠成功完成本次实验。①血管损伤14d,可见明显的新生内膜;损伤组和治疗组的内膜面积、内膜／中膜面积的比值较对照组增大（P〈0．05）;与损伤组比较,治疗组内膜／中膜面积的比值减少,管腔面积增加26％（P〈0．05）。②对照组血管偶可见单个散在的凋亡细胞;损伤组凋亡细胞阳性率为（12．3±1．8）％,与对照组比较,差异有统计学意义（P〈0．05）;治疗组凋亡细胞数目增多,凋亡细胞阳性率达（26．8±3．2）％,与损伤组比较,差异有统计学意义（P〈0．05）。凋亡细胞主要位于新生内膜。结论瑞舒伐他汀可抑制大鼠颈动脉球囊损伤后的内膜增生,可促进大鼠颈动脉球囊损伤后的细胞凋亡。瑞舒伐他汀促进细胞凋亡的作用可能与其抑制内膜增生有关。     

抗肿瘤药物DIM防治兔颈动脉球囊损伤术后再狭窄的实验研究

目的：观察DIM对兔血管成形术后再狭窄内膜增生的影响。方法：随机将兔分为假手术组、模型组及大、小剂量DIM治疗组，DIM做成乳剂后予腹腔注射给药。术前3 d开始给药，每只给药体积均为2 mL/d，假手术组与模型组予等体积的生理盐水。术后4周全部将兔处死，行HE染色观察动脉形态学改变，同时进行PDGF、TGF-β1的免疫组化及〖STBX〗bcl-2〖STBZ〗的原位杂交检测并计算其阳性率。结果：损伤动脉内膜厚度及面积、内膜/中膜面积与内膜/中膜厚度比显著增加。与模型组相比，DIM小剂量组的内膜厚度、内膜面积及内膜/中膜面积与厚度比、PDGF、TGF-β1与〖STBX〗bcl-2〖STBZ〗的阳性表达率均有所下降，但无显著差异(P＞0.05)，而DIM大剂量组效果显著，具有显著差异(P＜0.01)。结论：DIM可以抑制PTCA术后再狭窄的形成，其作用机制可能与抑制血管平滑肌细胞增殖及细胞生长因子和促进细胞凋亡有关。     

Different inflammatory response and oxidative stress in neointimal hyperplasia after balloon angioplasty and stent implantation in cholesterol-fed rabbits

Inflammatory responses appear to play an important role in the occurrence of restenosis following coronary intervention. However, the contribution of C-reactive protein (CRP) and oxidative stress to restenosis after balloon angioplasty and stent implantation remains unclear. The aim of this study was to examine this issue using hyperlipidemic rabbits. Rabbits were divided into two groups; they were fed with a 0.5% cholesterol diet and with a mixed 0.5% cholesterol and 0.5% probucol diet. Each group of rabbits underwent balloon injury and stent implantation in right and left iliac arteries, respectively. Eight weeks after the intervention, we examined luminal stenosis, neointimal hyperplasia, immunoreactivity for macrophage, CRP and oxidized phosphatidylcholine (oxPC), and also the expression of CRP mRNA. The degrees of neointimal hyperplasia and immunopositive areas (%) for macrophage, CRP, and oxPC in the neointima were significantly higher after stent implantation than after balloon injury, but CRP mRNA was undetectable in either artery. Anti-oxidant probucol reduced angiographic stenosis, neointimal hyperplasia, and macrophage- and oxPC-positive areas much more significantly after stenting. The results demonstrate that the inflammatory response to the development of neointimal hyperplasia differs after balloon injury and stent implantation and that CRP deposition and oxidative stress might be involved more significantly in neointimal development after stent implantation.     

tPA基因局部定位转染抑制兔动脉损伤后内膜增生的研究

目的: 观察局部转染组织型纤溶酶原激活物 (tPA)基因, 对手术损伤兔右髂外动脉后内膜增生的影响并探讨可能的机制。方法: 采用显微外科手术方法, 建立兔右髂外动脉损伤模型。将 105只新西兰大白兔随机分为 3组, 每组 35只。A组为生理盐水对照组, B组为脂质体介导的pBudCE4. 1转染组, C组为脂质体介导的pBudCE4. 1 /tPA转染组。用微注射器将各种转染液注入损伤的血管壁, 每组按实验终点(术后 2、3、7、14、28d)再分为 5个亚组, 每个亚组 7只兔。于术后各实验终点, 取损伤段的血管用于病理学检查、电镜观察、RT PCR和免疫组化染色检查。结果: 与A组和B组相比较, 术后各时间点C组血管内膜的厚度、内膜的面积和血管腔的狭窄率均显著减小 (P<0. 01)。术后 28d时, C组血管腔的狭窄率比A组和B组分别降低了 51. 5%和54. 2%。术后各时间点, C组血管壁的tPAmRNA的表达量明显高于A组和B组(P<0. 01), 在术后 7d到达高峰, 并持续到 28d。扫描电镜观察显示, C组的血管壁只见少量血小板附着, 未见血栓形成; 而A组和B组的血管壁可见大量血小板黏附聚集, 且有血栓形成。免疫组化染色显示, C组的血管壁血小板源性生长因子(PDGF)阳性细胞的百分率明显低于A组和B组(P<0. 01)。A组和B组之间相比较, 以上数据差异无显著性(P>     

Urinary trypsin inhibitor reduced neointimal hyperplasia induced by systemic inflammation after balloon injury in rabbits

Objectives

The aims of this study were to evaluate the effect of urinary trypsin inhibitor (UTI) on the regulation of inflammatory cytokines induced by lipopolysaccharide (LPS) and the reduction of neointimal formation in rabbits.

Methods and results

Rabbits subjected to iliac artery balloon injury were randomly divided into three groups: control group (balloon injury), LPS group (LPS + balloon injury) and UTI group (UTI + LPS + balloon injury). Systemic markers of inflammation (serum IL-1β and TNF-α levels measured by ELISA) were increased after LPS administration. Arterial nuclear factor-κB (NF-κB/p65) at 28 days after injury was 31.50 ± 7.08 % of total cells in controls and 73.50 ± 6.90 % in LPS group (P < 0.05). Morphometric analysis of the injured arteries at 28 days revealed significantly increased luminal stenosis (45.81 ± 5.31 vs 27.93 ± 2.85 %, P < 0.05) and neointima-to-media ratio (1.40 ± 0.15 vs 0.68 ± 0.12, P < 0.05) in LPS-treated animals compared with controls. This effect was reduced by UTI administration. Serum IL-1β and TNF-α levels and NF-κB/p65 expression were significantly increased in correlation with the severity of intimal hyperplasia and inhibited by UTI.

Conclusions

Systemic inflammatory response concurrently with arterial vascular injury facilitated neointimal formation. UTI reduced neointimal hyperplasia by regulating inflammatory response and could be considered as a potential anti-restenosis supplement.     

强力霉素影响基质金属蛋白酶活性和血管重构的实验研究

目的：观察强力霉素对损伤动脉组织中基质金属蛋白酶（MMP）活性的抑制作用，并探讨强力霉素对血管平滑肌细胞增殖、动脉内膜增生、管腔重构的影响。方法:球囊导管扩张动脉的方法建立大鼠颈总动脉损伤模型。治疗组用强力霉素30 mg·kg^-1·d^-1干预。明胶酶谱法测定损伤动脉组织中MMPs的活性。用HE染色、VVG染色、免疫组化标记α-actin和增殖细胞核抗原的方法观察损伤动脉内膜厚度、管腔重构及平滑肌细胞增殖的情况。结果:①强力霉素治疗组MMP-9活性在术后24 h、3 d分别比对照组低26.3％、34.5％（P<0.01）；MMP-2活性在术后7 d比对照组低40.0％（P<0.01）。②强力霉素治疗使术后7 d内膜平滑肌细胞增殖率（43.23％±1.06％）显著低于对照组（62.76％±1.02％）（P<0.01）；使术后14 d、28 d新生内膜厚度比对照组分别少32.0％、38.8％（P<0.01），而管腔面积比对照组多58.0％、90.4％（P<0.01） 。结论：强力霉素可以显著降低血管损伤后MMPs活性，抑制内膜平滑肌细胞的增殖、新生内膜增生以及管腔重构，提示它可能具有防治PTCA术后再狭窄的作用。     

A comparison of stent-induced stenosis in coronary and peripheral arteries

BACKGROUND AND OBJECTIVES: Restenosis is a complication of interventional procedures such as angioplasty and stenting, often limiting the success of these procedures. Knowledge regarding the relative behaviour of different arteries after these procedures is limited, despite the extensive use of different vascular models. Although the results from studies using different vessels are analysed to predict the behaviour of coronary arteries and other vasculature, direct controlled comparisons between different arteries are necessary for a better understanding of the differential response to restenosis. METHODS: This study examines the response to stenting in coronary and internal iliac arteries as characterised by intimal hyperplasia and restenosis. In a swine model of in-stent stenosis, coronary arteries exhibited higher levels of intimal hyperplasia and per cent stenosis than internal iliac arteries. RESULTS: After normalisation for injury score, coronary arteries were found to undergo 47% more intimal hyperplasia (p<0.05), whereas per cent stenosis normalised for injury score tended to be higher (p = 0.01). Other measurements reflecting post-stenting intimal hyperplasia (maximal intimal thickness, medial area) did not exhibit significant differences between the artery groups. CONCLUSIONS: These results show that coronary vessels are more prone to develop significant intimal hyperplasia and subsequent restenosis than internal iliac vessels. A better insight into how different arteries and arterial components behave is important in understanding and developing newer and better therapeutic measures for restenosis.     

The effect of quercetin on neointima formation in a rat artery balloon injury model

This study aimed at investigating the effect of quercetin on neointima hyperplasia in the abdominal aorta of rats after balloon injury and expressions of related growth factors. Fifty-four healthy male Sprague-Dawley rats were randomly divided into five groups: a sham-operation group (sham, n=6), a control group (control, n=12), and three quercetin-treated groups: Q50 group (50 mg/kg body weight/day, n=12), Q100 group (100 mg/kg body weight/day, n=12), and Q200 group (200 mg/kg body weight/day, n=12) 3 days before balloon injury until the end of the experiment. Fourteen days after injury, rats were killed, and the abdominal aortas were harvested. Hematoxylin–eosin staining showed that quercetin significantly reduced the neointimal areas and the intimal to medial ratio in the Q100 and Q200 groups 14 days after injury. Immunohistochemical analysis showed that quercetin significantly inhibited PCNA, PDGF-BB, b-FGF, and TGF-β1 expressions in the neointima. Masson's trichrome showed that quercetin significantly reduced collagen deposition in the neointima. We concluded that quercetin significantly inhibited neointimal hyperplasia in rat abdominal aorta 14 days after injury in relatively high doses. This effect of quercetin might be partially attributed to the suppression of PDGF-BB, b-FGF, and TGF-β1 expressions.